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Reconcile medical bills against insurance statements with Claude Cowork

PartialEvidence: Described by posterPosted Last checked

Claude Cowork found over $8k in possible Aetna errors in 24 hours for a Reddit poster, but repayment is unconfirmed: a partial result.

How to use this

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  2. Open the tool the case used (or a similar one) and paste the prompt; results may differ from the original.
  3. Paste it into the message box.
  4. Send it, then read the answer before acting on it.
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Prompt

Recreated prompt

The source didn't share its exact prompt, so we wrote one from what it describes. The result shown is the source's, not ours.

What the prompt labels mean

The person didn't share their exact words, so we wrote this from what they described. We haven't tested it, and they didn't use this exact version.

Each time I drop an invoice or explanation of benefits (EOB) into this folder, match it to the right claim and check whether Aetna paid it properly. Track everything in one place, flag any errors and help me file appeals.

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ChatGPT Gemini Grok Claude

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The source used Claude Cowork, which can take actions in a browser or app. These are general chat tools, so results may differ, and a normal chat may only give you a plan.

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Optional stronger version

Our rewrite with extra checks. The poster didn't test it.

Before you start, ask me 1–3 short questions about the details below and wait for my answers. Once I've answered, confirm the plan in one line and run the whole task start to finish.

Goal: Reconcile my medical invoices against insurance statements and flag payments that look wrong.

Questions to ask me first:
- Which insurer and plan year, and are the providers in or out of network?
- What's your deductible and out-of-network reimbursement rate?
- Where are the invoices and statements saved?

Inputs (fill in or confirm):
- Folder with invoices and EOBs: [FOLDER]
- Plan details (deductible, coinsurance, out-of-network rate): [PLAN]
- Claims already appealed: [APPEALED]

Rules:
- Match each invoice to its EOB by date of service, provider and amount.
- Explain why each flagged item looks wrong, using the plan details I gave you.
- Label items 'likely error' or 'needs checking'; don't claim money is owed without showing the math.
- Draft appeals but don't send anything without my OK.
- Keep a tracker with status and follow-up dates.

Checkpoint: Show me the reconciliation table before drafting any appeals.

If you get stuck: If a document is unreadable or missing, list it instead of guessing.

Verify before you finish: Recheck totals and plan math for every flagged item.

Output: A tracker spreadsheet and draft appeal letters.

Done when: Every invoice is matched, and each error has an appeal filed or a note on why not.

AI tool

Claude Cowork

Outcome

A Reddit poster with a number of out-of-network medical bills was good at submitting them for reimbursement but bad at tracking whether Aetna paid correctly. The poster set up Claude Cowork to reconcile invoices against explanation of benefits statements dropped into a shared folder. Within 24 hours, it had found more than $8k in what the poster called errors on Aetna's part and helped file the appeals. The post doesn't say whether any money has been paid back yet.

Evidence: Described by posterThe person describes what happened in words, without screenshots or video.

Known limitations

PartialThe source says it only partly worked, or had a significant problem a person had to deal with.

What went wrong: Errors were found and appeals filed, but the post doesn't confirm any money was recovered.

Source

Posted
by Reddit user (r/ClaudeCowork)
Last checked
Method:
How we verify

https://www.reddit.com/r/ClaudeCowork/comments/1u4yk06/claude_is_helping_me_get_8k_from_aetna/

Context: The source date is estimated from the Reddit post ID, since the page shows only a relative age.

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